US20080161835A1 - Sinus membrane perforation patching material carrying instrument - Google Patents

A sinus membrane perforation patching material carrying and insertion instrument, comprising a central support for a quantity of a sinus membrane patching material and moveable outer supports spaced laterally outward of the central support for laterally supporting and expanding the patching material as it is forced by the central support upward over the sinus perforation to form a relatively thin laterally extending patch sealed to the sinus membrane and closing and sealing the perforation.

RELATED PATENT APPLICATIONS

• The present application claims the benefit of U.S. Provisional Patent application Ser. No. 60/882,940 filed Dec. 31, 2006, which is herein incorporated by reference. The present application also relates to the subject matter of the concurrently filed U.S. patent application Ser. No. ______, entitled “Internal Procedure For Closing Sinus Membrane Perforations” (Docket 07JY-5), that is incorporated herein by this reference.

BACKGROUND OF INVENTION

• The procedure described in the above-identified concurrently filed United States patent application, is directed to a sinus membrane patching procedure that may be employed if a sinus membrane perforation should occur during a dental procedure or is discovered as having been previously formed during an independent dental procedure or as a result of a physical accident suffered by the patient.

• In the membrane patching procedure described in the concurrently filed United Sates patent application, an opening is created in the sinus floor of a patient to expose the portion of the sinus membrane including the perforation. Then, a quantity of a sinus membrane patching material is inserted through the opening to a location adjacent the sinus perforation. Finally, the sinus membrane patching material is laterally expanded and forced against the sinus membrane to seal the perforation.

• The present invention is directed to an improved version of an instrument for inserting, laterally expanding and forcing sinus patching material against a sinus membrane to seal a perforation in the sinus membrane.

SUMMARY OF INVENTION

• Basically, the instrument of the present invention comprises a central support for a quantity of a sinus membrane patching material and moveable outer supports spaced laterally outward of the central support for laterally supporting and expanding the patching material as it is forced by the central support upward over the sinus perforation to form a relatively thin laterally extending patch sealed to the sinus membrane and closing and sealing the perforation.

BRIEF DESCRIPTION OF ACCOMPANYING DRAWINGS
• FIG. 1

  is a perspective of the preferred version of the instrument of the present invention.

• FIG. 2

  is a fragmentary right side view of an upper portion of the instrument of

  FIG. 1

  showing the central support extending upward beyond a right-side one of the outer supports.

• FIG. 3

  is a fragmentary front view of the upper portion of the instrument shown in

  FIG. 2

  illustrating the connection for the central support to a left-side one of the outer supports and the normal spacing of the outer supports from the central support.

DETAILED DESCRIPTION OF INVENTION

• As previously indicated, and as described more fully in the above-referenced concurrently filed United States patent application, in order to seal a sinus perforation according to the method described in that patent application, an opening is created in the sinus floor of a patient exposing a portion of the patient's sinus membrane including the perforation. Next, as shown in

  FIG. 3

  the above-referenced patent application, the actual patching of the sinus perforation may be preceded by a lifting and separation of the perforated sinus membrane from the sinus floor to form a pocket between a lower surface of the sinus membrane and the sinus floor. The patching of the perforation in the sinus membrane is then accomplished as shown in

  FIGS. 4A

  and B and

  FIG. 5

  of the above-referenced patent application where an appropriate standard sinus membrane patching material is introduced through the opening into the pocket using a patching material insertion tool designed to carry the material upward into the pocket to a location adjacent and just below the portion of the sinus membrane including the perforation. Basically, as shown in

  FIG. 4A

  , during insertion of the sinus membrane patching material through the opening and into the pocket, the outer supports and of the insertion tool are moved laterally against the central support and the patching material is carried by the upper surface of the central support and the upper surfaces of the outer supports. Thus supported, the patching material is moved by the insertion tool upward through the opening and into the pocket to a location adjacent to and immediately below the perforation in the sinus membrane. Then, as shown in

  FIG. 4B

  , the insertion tool is moved upwardly until the patching material engages the sinus membrane and extends slightly into the perforation. As this is accomplished, the outer supports are released and moved laterally outward from the central support to aid the central support in laterally extending the patching material to cover the lower surface of the sinus membrane adjacent the perforation and form a patch as shown in

  FIG. 5

  of the above-referenced patent application. In these regards, patching materials useful in the patching of sinus membrane perforations are usually a semi-solid material as initially mounted on the insertion tool as shown in

  FIG. 4A

  . However, when the patching material engages the moist surface of the sinus membrane it softens and becomes laterally extendable upon the release of the outer supports and shapeable by the central support to form a sticky adhesive patch covering the perforation and the adjacent lower surfaces of the sinus membrane in response to movement of the central support.

• More specifically, relative to the preferred version of the insertion instrument of the present invention and as illustrated in

  FIG. 1

  of the present patent application, the preferred insertion tool or

  instrument

  10 comprises a

  central support

  12 and

  outer supports

  14 and 16 laterally spaced from and laterally moveable relative to the

  central support

  12. The central support may comprise and is illustrated as comprising a

  ball

  18 supported by a vertically extending

  support rod

  20.

• As depicted in

  FIG. 1

  , the preferred design of the

  insertion instrument

  10 resembles surgical forceps or tweezers having a pair of laterally spaced tongs secured to and extending longitudinally upward from a base for inward lateral movement towards each other when lateral forces are simultaneously applied to the tongs to pinch the free ends of the tongs against each other. In such a preferred design, the

  outer supports

  14 and 16 of the

  instrument

  10 correspond to the pair of tongs of surgical forceps or tweezers, the outer supports being secured and extending longitudinally upward from a

  base

  22 of the

  instrument

  10.

• However, the illustrated

  insertion instrument

  10 differs in important structural and function features from such standard surgical forceps or tweezers.

• First, among these several structural and function differences, is the

  central support

  12, preferably comprising the

  ball

  18 secured to and supported atop the upper end of the vertically extending

  support rod

  20. As shown in the drawings, the

  ball

  18 extends upward above the upper ends of the

  outer supports

  14 and 16 so that the sinus membrane patching material will drape over the ball and downward onto the outer supports, particularly when the outer supports are moved laterally inward relative to the central support as by an inward pinching of the outer supports.

• Second, as shown in

  FIGS. 1 and 3

  , at a mid-portion 21, the

  support rod

  20 is bent at an acute angle toward the

  outer support

  16. At a

  lower portion

  23, the

  support rod

  20 is bent to extend generally parallel to an inner surface of the

  outer support

  16. Then, at its

  lower end

  25, the

  support rod

  20 is hook-shaped, looped around and secured (as by welding) to a

  pin

  31 connected to and extending laterally from the

  outer support

  16 to pass through a

  guide hole

  33 in the

  outer support

  14 when the outer supports are pinched together.

• Also, among the important structural and functional differences between the

  insertion instrument

  10 and prior surgical forceps and tweezers is the angling of the upper portions of the central and outer supports. As shown in

  FIGS. 1 and 2

  ,

  upper end portions

  26 and 28 of the

  outer support

  14 and

  upper end portions

  30 and 32 of the

  outer support

  16 and

  upper end portions

  34 and 36 of the

  support rod

  20 are each first bent rearward and upward at the same acute angle relative to a vertical central

  longitudinal axis

  24 of the

  instrument

  10 and then each bent forward and upward at the same acute angle also relative to the

  axis

  24. This is most clearly shown in

  FIG. 2

  where the

  upper portion

  26 of the

  outer support

  14 extending upward from the

  base connection

  22 is bent rearward along an

  axis

  27 at an acute angle of about 10 degrees relative to the

  instrument axis

  24 and then at an

  upper extension portion

  28 is bent forward along an

  axis

  29 at and acute angle of about 35 degrees relative to an axis 38 parallel to the

  instrument axis

  24 or about 125 degrees to the

  axis

  27.

• In practice, the above described angling of the central and outer supports aids in the support and lateral extension of the sinus patching material during the application of such material to a sinus membrane and in the forming of the patching material into a relatively thin sealing patch over a perforation in the sinus membrane.

• While a particular embodiment of the preferred insertion instrument of the present invention has been illustrated and described above, it is appreciated that changes and modifications may be made in the illustrated embodiment without departing from the spirit of the invention. Accordingly, the scope of present invention is to be limited only by the terms of the following claims.